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Frequency-based analysis of diastolic function: detrimental phase-shift of the pressure-flow relation characterizes

Y Wu1, S J Kovács

  • 1Cardiovascular Biophysics Laboratory, Washington University, St. Louis, MO, USA.

Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
|February 3, 2007
PubMed

Insights

Cardiologists can now quantitatively assess heart diastolic function (DF) using a novel frequency-based impedance method. This approach links E-wave characteristics to improved diastolic filling, offering a more precise alternative to visual assessment.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Current assessment of heart diastolic function (DF) relies on subjective visual interpretation of Doppler echocardiographic E-waves.
  • Existing methods lack quantitative precision, potentially leading to misclassification of diastolic patterns like 'delayed-relaxation'.
  • A need exists for a causal, quantitative method to assess left ventricular (LV) diastolic pressure-flow dynamics.

Purpose of the Study:

  • To introduce a frequency-based impedance analysis for quantitative assessment of diastolic function (DF).
  • To characterize the relationship between left ventricular (LV) pressure (P) and transmitral flow (Q) in the frequency domain.
  • To correlate impedance parameters with echocardiographic E-wave characteristics and clinical diastolic patterns.

Main Methods:

  • Simultaneous pressure-flow data were recorded during catheterization in 20 subjects.
  • Echocardiographic E-waves were analyzed using model-based image processing (MBIP) to determine a deceleration parameter (c).
  • Frequency-domain analysis of the P/Q relation yielded impedance Z(omega) and a complex reflection coefficient R* with phase angle (phi).

Main Results:

  • A linear relationship was found between the phase angle (phi) and the MBIP parameter (c).
  • Both phi and c differed significantly (p < 0.05) between groups with short and long deceleration times (DT).
  • The 'delayed-relaxation' pattern correlated with deviations of phi from its optimal value (pi).

Conclusions:

  • The frequency-based impedance method provides a quantitative measure of diastolic function (DF).
  • Deviations in phase angle (phi) indicate impaired diastolic filling, associated with the 'delayed-relaxation' pattern.
  • This approach offers a more objective assessment of diastolic pressure-flow dynamics, enhancing diagnostic accuracy.

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